Patterns of ZMC and Le Fort Fractures under the Impact of the COVID-19 Pandemic-"A Changing Face?"

Abstract

Background: The aim of this study was to analyze the impact of the COVID-19 pandemic on midfacial fracture patterns/distributions and circumstances in a German craniomaxillofacial trauma center. Methods: This retrospective study compared the midface fracture patterns (excluding nasal fractures) of patients in the pre-COVID (PC) era (February 2019-January 2020) with patients in the intra-COVID (IC) era (February 2020-January 2021). In addition to baseline characteristics, the type of midface fractures, the circumstances leading to midface fractures, and hospital admissions/treatments were analyzed. Results: During the COVID-19 pandemic, a reduction in the total number of midface fractures was observed (PC = 88 vs. IC = 57). No significant differences were found regarding the midfacial fracture localization between both periods. During the pandemic, there was a significant increase in falls, accidents at home, and virus/flu-associated syncopes. At the same time, a significant decrease in sports accidents, interpersonal violence, and alcohol-related accidents leading to midface fractures was recorded. Furthermore, there was a significant increase in accidents during the morning time with a simultaneous reduction in accidents during the nighttime. In addition to that, a significant delay in days from trauma leading to midface fracture until hospital admission and surgical treatment (ORIF) was revealed. Conclusions: Despite the limitations of a monocentric retrospective study, the current findings lead to the conclusion that the COVID-19 pandemic had a significant impact on the patterns and circumstances leading to midface fractures. Analyzing the specific characteristics of patients suffering from midfacial fractures under the influence of the COVID-19 period can represent added value in order to treat facial fractures in future pandemics.